Individual
LAUREN C WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3912 TRINDLE RD, CAMP HILL, PA 17011-4246
(717) 761-8740
(717) 761-8792
Mailing address
3912 TRINDLE RD, CAMP HILL, PA 17011-4246
(717) 761-8740
(717) 761-8792
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA061541
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103807191
—
PA
Enumeration date
06/01/2020
Last updated
01/18/2024
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